| CASE NUMBER | I-200-24080-816845 |
| CASE STATUS | Denied |
| RECEIVED DATE | 3/20/2024 |
| DECISION DATE | 3/22/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Physician |
| SOC CODE | 29-1221.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2024 |
| END DATE | 7/1/2027 |
| 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 | N.W. Pediatric Center, Inc. PS |
| TRADE NAME DBA | Northwest Pediatric Center |
| EMPLOYER ADDRESS1 | 1911 Cooks Hill Road |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Centralia |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98531 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +13607366778 |
| EMPLOYER PHONE EXT | 123 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | McCKay |
| EMPLOYER POC FIRST NAME | Lisa |
| EMPLOYER POC MIDDLE NAME | G |
| EMPLOYER POC JOB TITLE | Administrator |
| EMPLOYER POC ADDRESS1 | 1911 Cooks Hill Road |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Centralia |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98531 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +13607366778 |
| EMPLOYER POC PHONE EXT | 123 |
| EMPLOYER POC EMAIL | lmckay@nwpeds.com |
| AGENT REPRESENTING EMPLOYER | No |
| AGENT ATTORNEY LAST NAME | |
| AGENT ATTORNEY FIRST NAME | |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | |
| AGENT ATTORNEY STATE | |
| AGENT ATTORNEY POSTAL CODE | |
| AGENT ATTORNEY COUNTRY | |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | |
| LAWFIRM NAME BUSINESS NAME | |
| STATE OF HIGHEST COURT | |
| NAME OF HIGHEST STATE COURT | |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1911 Cooks Hill Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Centralia |
| WORKSITE COUNTY | LEWIS |
| WORKSITE STATE | WA |
| WORKSITE POSTAL CODE | 98531 |
| WAGE RATE OF PAY FROM | 175000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $180,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $122,429.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | |
| PW OES YEAR | |
| PW OTHER SOURCE | Survey |
| PW OTHER YEAR | 2024 |
| PW SURVEY PUBLISHER | FLC Prevailing Wage |
| PW SURVEY NAME | Pediatrician, General |
| TOTAL WORKSITE LOCATIONS | 1 |
| 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 and Employment |
| PREPARER LAST NAME | McKay |
| PREPARER FIRST NAME | Lisa |
| PREPARER MIDDLE INITIAL | G |
| PREPARER BUSINESS NAME | N.W. Pediatric Center, Inc. PS |
| PREPARER EMAIL | lmckay@nwpeds.com |
| BEGIN DATE CONVERTED | 2024-01-07 |
