| LCA CASE NUMBER | I-200-20057-354233 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-02-26 |
| DECISION DATE | 2020-03-04 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician |
| SOC CODE | 29-1069.03 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-07-15 |
| END DATE | 2023-07-14 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Northwest Permanente P.C., Physicians & Surgeons |
| EMPLOYER ADDRESS1 | 393 E. Walnut Street |
| EMPLOYER ADDRESS2 | 2nd Floor |
| EMPLOYER CITY | Pasadena |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 91188 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16264055634 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Toy |
| EMPLOYER POC FIRST NAME | Alice |
| EMPLOYER POC JOB TITLE | Senior Paralegal |
| EMPLOYER POC ADDRESS1 | 393 E. Walnut Street |
| EMPLOYER POC ADDRESS2 | 2nd Floor |
| EMPLOYER POC CITY | Pasadena |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 91188 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16264055634 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Brollesy |
| AGENT ATTORNEY FIRST NAME | Hany |
| AGENT ATTORNEY MIDDLE NAME | S |
| AGENT ATTORNEY ADDRESS1 | 13 Chestnut Court |
| AGENT ATTORNEY CITY | Cedar Grove |
| AGENT ATTORNEY STATE | NJ |
| AGENT ATTORNEY POSTAL CODE | 07009 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12012182837.0 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Brollesy Law LLC |
| STATE OF HIGHEST COURT | NJ |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1.0 |
| SECONDARY ENTITY | Y |
| SECONDARY ENTITY BUSINESS NAME | Legacy Salmon Creek Medical Center |
| WORKSITE ADDRESS1 | 2211 NE 139th St. |
| LCA CASE WORKLOC1 CITY | Vancouver |
| WORKSITE COUNTY | CLARK |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 98686 |
| LCA CASE WAGE RATE FROM | 111.0 |
| LCA CASE WAGE RATE TO | 150.0 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 110.4 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 2.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | BROLLESY |
| PREPARER FIRST NAME | HANY |
| PREPARER MIDDLE INITIAL | S |
| PREPARER BUSINESS NAME | Brollesy Law LLC |
| PREPARER EMAIL | [email protected] |
