| CASE NUMBER | I-200-24227-267311 |
| CASE STATUS | Certified |
| RECEIVED DATE | 8/14/2024 |
| DECISION DATE | 8/21/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Physician - Internal Medicine |
| SOC CODE | 29-1216.00 |
| SOC TITLE | General Internal Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/23/2024 |
| END DATE | 9/22/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | PeaceHealth |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1115 SE 164th Avenue |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Vancouver |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98683 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +13607291279 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Karnes |
| EMPLOYER POC FIRST NAME | Thomas |
| EMPLOYER POC MIDDLE NAME | M. |
| EMPLOYER POC JOB TITLE | Senior Vice President, General Counsel |
| EMPLOYER POC ADDRESS1 | 1115 SE 164th Avenue |
| EMPLOYER POC ADDRESS2 | Dept. 302 |
| EMPLOYER POC CITY | Vancouver |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98683 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +13607291279 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | TKarnes@peacehealth.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | LaMorticella |
| AGENT ATTORNEY FIRST NAME | Melina |
| AGENT ATTORNEY MIDDLE NAME | Cecilia |
| AGENT ATTORNEY ADDRESS1 | 888 SW Fifth Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 1600 |
| AGENT ATTORNEY CITY | Portland |
| AGENT ATTORNEY STATE | OR |
| AGENT ATTORNEY POSTAL CODE | 97204 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +15038022122 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | melina.lamorticella@tonkon.com |
| LAWFIRM NAME BUSINESS NAME | Tonkon Torp LLP |
| STATE OF HIGHEST COURT | OR |
| NAME OF HIGHEST STATE COURT | Oregon Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1990 Hospital Drive |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Sedro-Woolley |
| WORKSITE COUNTY | SKAGIT |
| WORKSITE STATE | WA |
| WORKSITE POSTAL CODE | 98284 |
| WAGE RATE OF PAY FROM | 239,200.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $284,378.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $239,200.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | N/A |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-11-09 |
