We study Multi-Agent Path Finding for arrangements of labeled agents in the interior of a simply connected domain: Given a unique start and target position for each agent, the goal is to find a sequence of parallel, collision-free agent motions that minimizes the overall time (the makespan) until all agents have reached their respective targets. A natural case is that of a simply connected polygonal domain with axis-parallel boundaries and integer coordinates, i.e., a simple polyomino, which amounts to a simply connected union of lattice unit squares or cells. We focus on the particularly challenging setting of densely packed agents, i.e., one per cell, which strongly restricts the mobility of agents, and requires intricate coordination of motion. We provide a variety of novel results for this problem, including (1) a characterization of polyominoes in which a reconfiguration plan is guaranteed to exist; (2) a characterization of shape parameters that induce worst-case bounds on the makespan; (3) a suite of algorithms to achieve asymptotically worst-case optimal performance with respect to the achievable stretch for cases with severely limited maneuverability. This corresponds to bounding the ratio between obtained makespan and the lower bound provided by the max-min distance between the start and target position of any agent and our shape parameters. Our results extend findings by Demaine et al. (SIAM Journal on Computing, 2019) who investigated the problem for solid rectangular domains, and in the closely related field of Permutation Routing, as presented by Alpert et al. (Computational Geometry, 2022) for convex pieces of grid graphs.