| CASE NUMBER | I-200-25009-607225 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/9/2025 |
| DECISION DATE | 1/16/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Advanced Registered Nurse Practitioner |
| SOC CODE | 29-1171.00 |
| SOC TITLE | Nurse Practitioners |
| FULL TIME POSITION | N |
| BEGIN DATE | 1/20/2025 |
| END DATE | 1/19/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Community Health of Central Washington |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 501 S. 5th Ave. |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Yakima |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98902 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15095746162 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621498 |
| EMPLOYER POC LAST NAME | McClintock |
| EMPLOYER POC FIRST NAME | Laura |
| EMPLOYER POC MIDDLE NAME | Ann |
| EMPLOYER POC JOB TITLE | Human Resources Director |
| EMPLOYER POC ADDRESS1 | 501 S. 5th Ave. |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Yakima |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98902 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15095746162 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | laura.mcclintock@chcw.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Roach |
| AGENT ATTORNEY FIRST NAME | Eamonn |
| AGENT ATTORNEY MIDDLE NAME | Patrick Sullivan |
| AGENT ATTORNEY ADDRESS1 | 9221 Sandifur Parkway Suite C |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Pasco |
| AGENT ATTORNEY STATE | WA |
| AGENT ATTORNEY POSTAL CODE | 99301 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 15095477587 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | eroach@roachlaw.com |
| LAWFIRM NAME BUSINESS NAME | Roach & Bishop LLP |
| STATE OF HIGHEST COURT | WA |
| NAME OF HIGHEST STATE COURT | Supreme Court of Washington |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 521 E. Mountain View Ave. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Ellensburg |
| WORKSITE COUNTY | KITTITAS |
| WORKSITE STATE | WA |
| WORKSITE POSTAL CODE | 98926 |
| WAGE RATE OF PAY FROM | $57.69 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $56.17 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| 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 |
| PREPARER LAST NAME | Todd |
| PREPARER FIRST NAME | Rachel |
| PREPARER MIDDLE INITIAL | B |
| PREPARER BUSINESS NAME | Roach & Bishop, LLP |
| PREPARER EMAIL | rtodd@roachlaw.com |
| BEGIN DATE CONVERTED | 2025-01-20 |
