| LCA CASE NUMBER | I-200-24220-251788 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2024-08-07 |
| DECISION DATE | 2024-08-14 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician Family Medicine |
| SOC CODE | 29-1215.00 |
| SOC TITLE | Family Medicine Physicians |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2024-10-21 |
| END DATE | 2027-10-20 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Providence Health & Services - Washington |
| TRADE NAME DBA | Providence St. Mary Medical Center |
| EMPLOYER ADDRESS1 | 1801 Lind Ave SW Morin Bldg |
| EMPLOYER ADDRESS2 | 1st Floor |
| EMPLOYER CITY | Renton |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98057 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14256156359 |
| EMPLOYER FEIN | 91-1996732 |
| NAICS CODE | 6221 |
| EMPLOYER POC LAST NAME | Jeanes |
| EMPLOYER POC FIRST NAME | Maria |
| EMPLOYER POC MIDDLE NAME | Salazar |
| EMPLOYER POC JOB TITLE | In-House Immigration Counsel |
| EMPLOYER POC ADDRESS1 | 1801 Lind Ave SW Morin Bldg |
| EMPLOYER POC ADDRESS2 | 1st Floor |
| EMPLOYER POC CITY | Renton |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98057 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14256156359 |
| EMPLOYER POC EMAIL | maria.jeanes@providence.org |
| AGENT REPRESENTING EMPLOYER | False |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 401 W Poplar St |
| WORKSITE ADDRESS2 | Providence St. Mary Medical Center |
| LCA CASE WORKLOC1 CITY | Walla Walla |
| WORKSITE COUNTY | WALLA WALLA |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 99362 |
| LCA CASE WAGE RATE FROM | 138216 |
| LCA CASE WAGE RATE TO | 250000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 138216 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |