| CASE NUMBER | I-200-24320-477452 |
| CASE STATUS | Certified |
| RECEIVED DATE | 11/15/2024 |
| DECISION DATE | 11/22/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | RN Charge Nurse |
| SOC CODE | 29-1141.00 |
| SOC TITLE | Registered Nurses |
| FULL TIME POSITION | Y |
| BEGIN DATE | 12/16/2024 |
| END DATE | 12/15/2027 |
| 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 | Legacy Emanuel Hospital and Medical Center |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 2801 N. Gantenbein Ave |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Portland |
| EMPLOYER STATE | OR |
| EMPLOYER POSTAL CODE | 97227 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15034155772 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Renteria |
| EMPLOYER POC FIRST NAME | Ernest |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | HR Compliance Associate |
| EMPLOYER POC ADDRESS1 | 1919 NW Lovejoy |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Portland |
| EMPLOYER POC STATE | OR |
| EMPLOYER POC POSTAL CODE | 97209 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15034155772 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | erenteria@lhs.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Ness |
| AGENT ATTORNEY FIRST NAME | Gretel |
| AGENT ATTORNEY MIDDLE NAME | M |
| AGENT ATTORNEY ADDRESS1 | 1200 NW Naito Parkway |
| AGENT ATTORNEY ADDRESS2 | Suite 200 |
| AGENT ATTORNEY CITY | Portland |
| AGENT ATTORNEY STATE | OR |
| AGENT ATTORNEY POSTAL CODE | 97209 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 15032411320 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | gmn@pbl.net |
| LAWFIRM NAME BUSINESS NAME | Parker Butte & Lane PC |
| STATE OF HIGHEST COURT | OR |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | Unity Center for Behavioral Health |
| WORKSITE ADDRESS2 | 1225 NE 2nd Ave |
| WORKSITE CITY | Portland |
| WORKSITE COUNTY | MULTNOMAH |
| WORKSITE STATE | OR |
| WORKSITE POSTAL CODE | 97232 |
| WAGE RATE OF PAY FROM | $65.72 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $62.31 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| 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 | Wolters |
| PREPARER FIRST NAME | Suzy |
| PREPARER MIDDLE INITIAL | J |
| PREPARER BUSINESS NAME | Parker Butte and Lane PC |
| PREPARER EMAIL | sjw@pbl.net |
| BEGIN DATE CONVERTED | 2024-12-16 |
