| CASE NUMBER | I-200-25062-738456 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/3/2025 |
| DECISION DATE | 3/10/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1215.00 |
| SOC TITLE | Family Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/1/2025 |
| END DATE | 8/31/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| EMPLOYER NAME | Lourdes Physician Services, LLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 330 Seven Springs Way |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Brentwood |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37027 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15092215980 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Bradbury |
| EMPLOYER POC FIRST NAME | Tamie |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Medical Staff Services - Trios Health |
| EMPLOYER POC ADDRESS1 | 7425 Wrigley Drive |
| EMPLOYER POC ADDRESS2 | Suite 100 |
| EMPLOYER POC CITY | Pasco |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 99301 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15092215980 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | tamie.bradbury@trioshealth.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Duong |
| AGENT ATTORNEY FIRST NAME | Hon-Vinh |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 511 Union Street |
| AGENT ATTORNEY ADDRESS2 | Suite 2700 |
| AGENT ATTORNEY CITY | Nashville |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 37219 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16158508936 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | flag@hklaw.com |
| LAWFIRM NAME BUSINESS NAME | Holland & Knight LLP |
| STATE OF HIGHEST COURT | TN |
| NAME OF HIGHEST STATE COURT | Tennessee Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 7425 Wrigley Drive |
| WORKSITE ADDRESS2 | Ste. 100 |
| WORKSITE CITY | Pasco |
| WORKSITE COUNTY | FRANKLIN |
| WORKSITE STATE | WA |
| WORKSITE POSTAL CODE | 99301 |
| WAGE RATE OF PAY FROM | $192,546.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $250,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $192,546.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| 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 | Perez |
| PREPARER FIRST NAME | Alana |
| PREPARER MIDDLE INITIAL | L. |
| PREPARER BUSINESS NAME | Holland & Knight, LLP |
| PREPARER EMAIL | alana.perez@hklaw.com |
| BEGIN DATE CONVERTED | 2025-09-01 |
