| CASE NUMBER | I-200-24365-577550 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/30/2024 |
| DECISION DATE | 1/7/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Nephrologist |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/15/2025 |
| END DATE | 10/31/2027 |
| 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 | Mt. Baker Nephrology Associates, Inc., P.S. |
| TRADE NAME DBA | Mount Baker Nephrology Associates |
| EMPLOYER ADDRESS1 | 3104 Squalicum Parkway |
| EMPLOYER ADDRESS2 | #101 |
| EMPLOYER CITY | Bellingham |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98225 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 13607349233 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621112 |
| EMPLOYER POC LAST NAME | Moss |
| EMPLOYER POC FIRST NAME | Larry |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Owner |
| EMPLOYER POC ADDRESS1 | 3104 Squalicum Parkway |
| EMPLOYER POC ADDRESS2 | #101 |
| EMPLOYER POC CITY | Bellingham |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98225 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 13607349233 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | lemoss@hinet.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 |
| AGENT ATTORNEY ADDRESS2 | SUITE C |
| 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 | WA STATE SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 3104 Squalicum Parkway |
| WORKSITE ADDRESS2 | #101 |
| WORKSITE CITY | Bellingham |
| WORKSITE COUNTY | WHATCOM |
| WORKSITE STATE | WA |
| WORKSITE POSTAL CODE | 98225 |
| WAGE RATE OF PAY FROM | $240,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $130,270.00 |
| PW UNIT OF PAY | Year |
| 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 | 3 |
| 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 | 2025-01-15 |
